The Pharmaceutical Journal
Vol 275 No 7357 p64
9 July 2005

This article
Reprint   Photocopy

PDF 140K, Acrobat Reader

The isle is full of noises more
Two near-fatalities illustrate the hazard of using “club drugs” more
Did leprosy follow our ancestors’ movements? more
A physician's opinion / Designed to destroy more

The isle is full of noises

As a common hazard of everyday existence in an advanced civilisation, noise is prominent, and by all the evidence is increasing year by year.

According to an account in The Lancet for 4 June, from an occupational scientist at Yale University, noise is not only a ubiquitous physical hazard, but its sudden absence can also unsettle a nervous individual. The sense of hearing in adults evolved at a period in human history when soft rustling in the forest acted as a signal alerting to danger from a prowler or detecting the proximity of game available for food. In our modern world we have to contend with amplified music and speech as well as traffic noise and other machine-made alerts. This may well annoy us — but the point is, does it threaten our health?

Prolonged exposure to a high level of noise in a place of work may induce hearing loss through high-frequency assaults to the nervous system. Living near an airport raises concern over possible physical or psychological effects of noise. In the same issue of The Lancet a study is published of more than 2,800 children aged between 9 and 10 who attended schools located near airports in Spain, the Netherlands and the UK. Investigators assessed noise levels from aircraft and other traffic and the possible effects upon health in general and on tests for cognitive performance of the schoolchildren. Chronic exposure adversely affected comprehension during reading sessions.

In a German study, children attending a school where noise was reduced after a local airport was moved showed improved reading skills and cognitive emery performance, whereas others who came into the new aircraft base area showed decreased scores.

It is argued that children exposed to stressful noise react by ignoring the new stimuli but at the same time paying less attention to the voice of their teacher. Unless background noise is at least 10dB below the level of the teacher’s voice, aural reception of the lesson is impaired. Excessive background noise in schools may also be due to poor ventilation and air conditioning design. Moreover, children attending school may have to return to homes where passing aircraft interfere with sleep patterns and so impair general health and ability to learn. Other environmental factors may include poor housing and crowding, and add to the psychological distress.

What applies to children undergoing education may also affect the general population by adding to the burden of sleep disorders and cardiovascular disease. Excessive noise in hospitals may adversely affect the outcome of residential treatment. It is coming to be accepted that efforts to reduce sources of environmental noise may become an integral part of preventive and curative medicine.

Back to Top

Two near-fatalities illustrate the hazard of using “club drugs”

So-called “club drugs” are fast gaining an evil reputation for the hazards they bring with them. The term is applied to illicit compounds that are abused as “recreational” drugs — an ill-advised description for substances that are taken only as stimulants or to relieve boredom and not for any therapeutic reason.

In the 30 June issue of the New England Journal of Medicine, Cynthia McGinn of Harvard Medical School describes two near-fatalities in college students who had taken an unidentified drug at a drinking party and were found unconscious in the basement of the building. The emergency team called thought that their condition was simple drunkenness, but they became deeply comatose, and one stopped breathing during transit to hospital.

These students did not smell of alcohol, nor did they have injection marks on their arms, but they had undergone respiratory arrest for no clear reason. Drugs that could have been responsible include gamma-hydroxybutyric acid (GHB), methylenedioxymethamphetamine (MDMA, “ecstasy”), flunitrazepam and ketamine. In this instance, it seems that gamma-hydroxybutyric acid was the most likely cause.

It is disturbing to learn that internet sites offer instructions for making such illicit drugs from household chemicals, over-the-counter medicines and prescription products. As for gamma-hydroxybutyric acid, as described in a review article in the same issue of NEJM, it is a clear, odourless and tasteless drug, alleged to be aphrodisiac and amnesiac. Euphoria follows within 30 minutes of ingestion, proceeding to dizziness, nausea and vomiting, myoclonic jerks, confusion, agitation, hallucinations and seizures. In combination with alcohol, this drug can induce respiratory failure, coma and death.

Back to Top

Did leprosy follow our ancestors’ movements?

It is pointed out in the 13 May issue of Science that leprosy was a human scourge long before the Black Death or AIDS was heard of. Although present for millennia, it remains an enigma.

A Pasteur Institute study of rare DNA differences among strains of leprosy isolated from various corners of the earth has indicated that the disease originated in East Africa or the Near East. But the theory that colonialisation and the slave trade helped to introduce it into West Africa and the New World is challenged.

Confirmed reports of leprosy first appeared about 600BC in sacred Indian texts describing loss of sensation in fingers and toes. By medieval times the deforming lesions and decaying flesh characteristic of the disease prompted burning at the stake or banishment to distant regions. In the 1940s some control with antibiotics was possible, but in poor regions leprosy persists, with more than half a million new cases being reported each year.

The leprosy bacillus has little genetic diversity, but by means of single nucleotide polymorphism studies a total of 175 strains worldwide has been divided into four types — type 1 in Central Asia, type 2 in Ethiopia, type 3 in Europe, north Africa and America and type 4 in West Africa and the Caribbean.

Mutation patterns suggest an origin in Central Asia or East Africa, and so India cannot be stigmatised as its cradle. There is no basis for the story that Alexander the Great’s soldiers brought leprosy to Europe from India.

Back to Top

And I quote …

A physician’s opinion
Tobacco drieth the brain, dimmeth the sight, vitiateth the smell, hurteth the stomach, destroyeth the concoction, disturbeth the humors and spirits, corrupteth the breath, induceth a trembling of the limbs, exsiccateth the windpipe, lungs, and liver, annoyeth the milt, scorcheth the heart, and causeth the blood to be adjusted.
— Tobias Venner (1577–1660), English physician: ‘Via recta ad vitam longam’.

Designed to destroy
Tobacco surely was designed / To poison, and destroy mankind
— Philip Freneau, (1752–1832), US poet.

Back to Top